FIELD
[0001] The present disclosure relates generally to medical devices and, more specifically,
to a lever action integrated slitter for removing a catheter, such as an introducer
sheath, or other elongate tubular member used to move an elongate medical instrument
at a desired position within a body.
BACKGROUND
[0002] The statements in this section merely provide background information related to the
present disclosure and may not constitute prior art.
[0003] Various devices have been proposed for introducing and/or positioning elongate medical
instruments in the human body. For instance, various catheter systems, introducer
sheaths, and other elongate tubular members have been proposed for these purposes.
More specifically, these devices include a proximal portion that remains outside the
body and a tubular portion that extends into the body. A lumen extends through the
proximal portion and the tubular portion. A medical instrument, such as a cardiac
pacemaker lead or other vascular instrument, passes through the lumen into the body,
and then the medical professional positions the medical instrument into a desired
position. For instance, in some embodiments, the medical instrument is positioned
within the patient's heart, blood vessel, or other portion of the body. Then, the
medical professional removes the tubular portion of the catheter system.
[0004] Many catheter systems have been proposed that are designed to be removed without
disturbing (i.e., inadvertently moving) the medical instrument from its desired position.
[0005] A catheter system as defined in the preamble of claim 1 is disclosed in
US 2006/167417.
[0006] For instance, some catheter systems include an elongate tubular member that can be
torn and peeled apart longitudinally while being pulled out of the body. Other systems
rely on an independent slitter with a blade that slits the elongate tubular member
as it is pulled out of the body.
SUMMARY
[0007] A catheter system for positioning of an instrument within a body is disclosed. The
catheter system includes a hub defining a lumen therethrough for passage of the instrument
toward the body. The system also includes an elongate tubular member defining a lumen
therethrough. The lumen of the elongate tubular member is in communication with the
lumen of the hub for further passage of the instrument toward the body. Moreover,
the system includes a slitter member that is coupled to the hub. The slitter member
is disposed to slit the elongate tubular member. The system additionally includes
a moveable member that is moveably coupled to the hub and that is coupled to the elongate
tubular member. The moveable member is operable to advance the elongate tubular member
toward the slitter member as the moveable member is moved relative to the hub. The
slitter member thereby slits the elongate tubular member.
[0008] Further areas of applicability will become apparent from the description provided
herein. It should be understood that the description and specific examples are intended
for purposes of illustration only and are not intended to limit the scope of the present
disclosure.
DRAWINGS
[0009] The drawings described herein are for illustration purposes only and are not intended
to limit the scope of the present disclosure in any way.
FIG. 1 is a perspective view of a catheter system according to various teachings of
the present disclosure;
FIG. 2 is a perspective view of the catheter system of FIG. 1 shown in a slitting
configuration;
FIG. 3 is a perspective view of a hub of the catheter system of FIG. 1;
FIG. 4 is a perspective view of a moveable member of the catheter system of FIG. 1;
FIG. 5 is a perspective view of a slitter member of the catheter system of FIG. 1;
FIG. 6 is a perspective view of other embodiments of a catheter system according to
the present disclosure;
FIG. 7 is a perspective view of the catheter system of FIG. 6 shown in a slitting
configuration;
FIG. 8 is a perspective view of still other embodiments of a catheter system according
to the present disclosure; and
FIG. 9 is a perspective view of still other embodiments of a catheter system according
to the present disclosure.
DETAILED DESCRIPTION
[0010] The following description is merely exemplary in nature and is not intended to limit
the present disclosure, application, or uses. It should be understood that throughout
the drawings, corresponding reference numerals indicate like or corresponding parts
and features.
[0011] Referring initially to FIGS. 1 and 2, a catheter system 10 is illustrated. The catheter
system 10 is operable for positioning a medical instrument 12, such as a cardiac pacemaker
lead, vascular instrument, a suture sleeve, or other elongate medical instrument,
within a body of a patient. It will be appreciated that, although the following discussion
will be related to positioning a cardiac pacemaker or other vascular instrument, the
catheter system 10 can be used for positioning any suitable medical instrument 12
without departing from the scope of the present disclosure. In the embodiments illustrated,
the catheter system 10 generally includes an engagement member 16 for removably attaching
the catheter system 10 and the medical instrument 12. In some embodiments, the engagement
member 16 couples to a standard valve 14 to achieve a removable luer-type coupling.
The medical instrument 12 passes through the valve 14 and through the catheter system
10 as will be described in greater detail.
[0012] The system 10 also includes a hub 18 (FIGS. 1-3) that defines a proximal end 20 and
a distal end 22. The hub 18 also defines a base 21, which can have a solid, rectangular
cross section, and a lumen portion 23, which can be hollow and tubular. The lumen
portion 23 defines a lumen 24 therethrough. The lumen 24 defines a longitudinal axis
X. In some embodiments, an outer surface 31 of the lumen portion 23 and the lumen
24 is tapered along the longitudinal axis X.
[0013] The hub 18 can also include a grip member 25 for holding the hub 18. In some embodiments,
the grip member 25 extends transversely away from the longitudinal axis X. In some
embodiments, the grip member 25 is integrally attached to the base 21 such that the
grip member 25 and the base 21 are monolithic. Moreover, in some embodiments, the
grip member 25 and base 21 are made out of a molded, polymeric material, such as nylon,
HDPE, polycarbonate, PU, ABS, composite materials, polymer blends such as rubber toughened
nylon, nylon co-polymers such as Pebax, or filled materials such as talc filled polypropylene.
[0014] As shown, the system 10 further includes an elongate tubular member 26. The elongate
tubular member 26 is hollow so as to define a lumen 28 extending therethrough. A proximal
end 27 of the tubular member 26 is coupled to the distal end 22 of the hub 18 such
that the lumen 28 of the tubular member 26 is in communication with the lumen 24 of
the hub 18. In some embodiments, the tubular member 26 is made out of a flexible,
polymeric material, such as Pebax, Nylon, PE, multi-layered extrusions, or braided
layered assemblies such as a Pebax/braid/PTFE liner & variable longitudinal durometer
tube assemblies.
[0015] As will be described in greater detail below, the medical instrument 12 can pass
through the proximal end 20 of the hub 18, through the lumen 24, and pass further
into the lumen 28 of the tubular member 26 to be positioned within the heart, blood
vessel, or other desired portion of the human body. Once the medical instrument 12
is properly positioned, the tubular member 26 can be slit and removed from the body
without disturbing or otherwise moving the medical instrument 12 from its desired
position as will be discussed.
[0016] Furthermore, the system 10 includes a slitter member 29 (FIGS. 1, 2, and 5). The
slitter member 29 can include a blade 30 and a spade 32. As shown in FIG. 5, the blade
30 includes a sharpened leading edge 34. The spade 32 is fixedly attached to the blade
30. In some embodiments, the blade 30 and spade 32 are made out of electro-polished
stainless steel and are laser welded together; however, it will be appreciated that
the blade 30 and spade 32 can be made out of any suitable material and can be attached
in any suitable manner without departing from the scope of the present disclosure.
Also, it will be appreciated that the blade 30 and spade 32 can be separate from each
other within the catheter system 10 without departing from the scope of the present
disclosure.
[0017] The spade 32 can include a leading portion 36 and a rear portion 38. In some embodiments,
the leading portion 36 is pointed and the spade 32 widens toward the rear portion
38 (i.e., the rear portion 38 is wider than the leading portion 36). The spade 32
is attached to the blade 30 such that the leading portion 36 is spaced forward from
the leading edge 34 of the blade. Also, in some embodiments, a top surface 39 of the
spade 32 is curved outward from the blade 30.
[0018] The slitter member 29 can be fixedly attached to the hub 18. As shown in FIGS. 1
and 2, the slitter member 29 can be fixed adjacent the distal end 22 of the hub 18
immediately forward of the lumen 24 of the hub 18. In some embodiments, the curved
top surface 39 of the spade 32 is continuous with respect to the end of the lumen
24 of the hub 18. Also, the slitter member 29 can be attached such that the leading
edge 34 of the blade 30 is disposed at a positive, acute angle with respect to the
longitudinal axis X. In other words, the portion of the leading edge 34 adjacent the
spade 34 is forward of the other portions of the leading edge 34. It will be appreciated
that once the slitter member 29 is attached to the hub 18, the slitter member 29 and
hub 18 are a single unit, which makes slitting of the tubular member 26 simple and
ergonomic as will be discussed in greater detail below.
[0019] Moreover, as shown in FIGS. 1, 2, and 4, the system 10 includes a moveable member
40 that is moveably coupled to the hub 18 and that is coupled to the elongate tubular
member 26 in a manner to be discussed below. As will be discussed, the moveable member
40 is operable to advance the elongate tubular member 26 toward the slitter member
29 as the moveable member 40 is moved relative to the hub 18. As such, the slitter
member 29 slits the elongate tubular member 26.
[0020] In some embodiments, the moveable member 40 includes a first coupling member 42 that
rotationally and removably couples the moveable member 40 to the lumen portion 23
of the hub 18. More specifically, the first coupling member 42 is rotationally and
removably coupled adjacent to the proximal end 20 of the hub 18 on a side of the longitudinal
axis X opposite from the grip member 25. As will be described in greater detail, the
moveable member 40 rotates about an axis R due to the first coupling member 42, and
the moveable member 40 also detaches from the hub 18 to move away from the axis R.
[0021] Also, in some embodiments, the moveable member 40 includes a second coupling member
44 that removably couples the moveable member 40 adjacent the distal end 22 of the
base 21 of the hub 18. In some embodiments, the second coupling member 44 is a coupling
fork 43 with a first arm 45 and a second arm 47 (FIG. 4). The first arm 45 and second
arm 47 removably couple to opposing sides of the hub 18 in a manner to be discussed
in greater detail below.
[0022] Additionally, the arms 45, 47 of the coupling fork 43 can each include a grooved
portion 68 (FIG. 4), and the hub 18 can include corresponding protrusions 70 (FIG.
3). The grooved portions 68 receive the corresponding protrusion 70 to removably couple
the coupling fork 43 and the hub 18. It will be appreciated that the hub 18 could
include the grooved portions 68, and the fork 43 could include the corresponding protrusions
70 without departing from the scope of the present disclosure.
[0023] The moveable member 40 also includes a central portion 46 that is generally disposed
between the first coupling member 42 and second coupling member 44. The central portion
46 is generally thin and elongate. Also, the central portion 46 can include curved
flanges 47 that extend transversely from opposite sides of the central portion 46.
The flanges 47 are curved outward from the central portion 46 to substantially mate
with the outer surface 31 of the hub 18. In some embodiments, the longitudinal taper
of the outer surface 31 substantially matches the longitudinal taper of the flanges
47 such that the flanges 47 mate and conform to the outer surface 31.
[0024] Furthermore, the moveable member 40 can include a handle portion 48. In some embodiments,
the handle portion 48 can be ring-shaped; however, it will be appreciated that the
handle portion 48 can be partially ring-shaped, the handle portion 48 can be axially
straight and extend transversely from the longitudinal axis X, or the handle portion
48 can have any other suitable shape. As shown in FIG. 1, the handle portion 48 is
disposed generally between the first and second coupling members 42, 44.
[0025] The central portion 46 of the moveable member 40 also includes a lever portion 49.
The lever portion 49 is generally straight along its axis. The lever portion 49 extends
between the handle portion 48 and the first coupling member 42.
[0026] In some embodiments, the first and second coupling members 42, 44, the handle portion
48, and the lever portion 49 are each integrally attached such that the moveable member
40 is monolithic. Also, in some embodiments, the moveable member 40 is made out of
a molded polymeric material, such as nylon, HDPE, polycarbonate, PU, ABS, composite
materials, polymer blends such as rubber toughened nylon, nylon co-polymers such as
Pebax, or filled materials such as talc filled polypropylene.
[0027] Additionally, the catheter system 10 can include a tube coupling member 50. The tube
coupling member 50 can be an elongate, flat braided shaft. The tube coupling member
50 is fixedly attached to the proximal end 27 of the tubular member 26. In some embodiments,
the tube coupling member 50 is separately attached to the tubular member 26 via an
adhesive, via an overmolding process, or by welding. Also, in some embodiments, the
tube coupling member 50 is integrally attached to the tubular member 26 such that
the tubular member 26 and the tube coupling member 50 are monolithic. Moreover, in
some embodiments, the tube coupling member 50 is partially curved to substantially
wrap around the outside of the spade 32 on both sides of the blade 30. Further rearward,
the tube coupling member 50 becomes thinner and more flat and lies atop the outer
surface 31 of the hub 18. In some embodiments, the tube coupling member 50 is sealed
to the hub 18 to keep contaminants out of the lumen 24 as will be discussed in greater
detail below.
[0028] The tube coupling member 50 generally couples the proximal end 27 of the tubular
member 26 and the lever portion 49 of the moveable member 40. In some embodiments,
the tube coupling member 50 is coupled to the moveable member 40 between the handle
portion 48 and the first coupling member 42, immediately adjacent the first coupling
member 42. Also, in some embodiments, the tube coupling member 50 extends into an
opening 51 of the lever portion 49 and is attached thereto using an adhesive, such
as cyanoacrylate. The tube coupling member 50 can also be attached to the moveable
member 40 via overmolding or by a mechanical grip fit. However, it will be appreciated
that the tube coupling member 50 can be coupled in any suitable manner without departing
from the scope of the present disclosure.
[0029] Thus, referring initially to FIG. 1, the operation of the catheter system 10 will
be discussed. The valve 14 is attached to the hub 18. Then, the tubular member 26
is inserted into the body (not shown) through a prepared incision (not shown). Next,
the medical instrument 12 is inserted by passing through the lumen 24 and further
passing through the lumen 28 into the body. The valve 14 can be configured to inhibit
backflow of bodily fluids and to facilitate positioning of the instrument 12 within
the body and/or dye injection. Also, once the instrument 12 is in the desired position
within the body, the valve 14 can be tightened to maintain the position of the instrument
12.
[0030] Then, the user grasps the grip member 25 with one hand and the handle portion 48
with the other hand. To begin slitting the tubular member 26, the user begins pulling
and rotating the moveable member 40 and away from the axis X, thereby pivoting the
moveable member 40 relative to the hub 18 about the axis R. This movement advances
the tubular member 26 toward the slitter member 29, and the blade 30 begins forming
a slit longitudinally in the tubular member 26. Also, because the handle portion 48
is spaced from the first coupling member 42 by the axial length of the lever portion
49, the lever portion 49 acts as a lever arm and provides a mechanical advantage for
slitting the tubular member 26. It will be appreciated that this mechanical advantage
can greatly facilitate slitting the tubular member 26, especially in the proximal
end 27 of the tubular member 26.
[0031] Also, because of the shape of the spade 32 and the relative position between the
spade 32 and blade 30 (described in detail above), the leading portion 36 of the spade
32 guides the elongate tubular member 26 toward the leading edge 34 of the blade 30.
Accordingly, the slitter member 29 creates a uniform slit longitudinally in the tubular
member 26, the tubular member 26 is unlikely to twist about its axis, and the medical
instrument 12 is less likely to be moved during slitting.
[0032] Also, the taper of the outer surface 31 of the hub 18 separates the tubular member
26 about the slit and guides the slit portion of the tubular member 26 toward the
proximal end 20 of the hub 18. As such, the tubular member 26 is unlikely to twist
about its axis, and the medical instrument 12 is less likely to move during slitting.
[0033] Once the moveable member 40 has been rotated to its apex about the first coupling
member 42, the user pulls the moveable member 40 further away from the hub 18 and
detaches the first coupling member 42 from the hub 18 (FIG. 2). Moreover, in some
embodiments, the moveable member 40 includes a rounded back surface 64 (FIGS. 1, 2,
and 4) located adjacent the first coupling member 42 on a side opposite the fin 54.
Once the moveable member 40 begins to detach from the hub 18, the rounded back surface
64 can continue to rotationally support the moveable member 40 on the hub 18. In other
words, the moveable member 40 rotates on the hub 18 via the rounded back surface 64.
[0034] Then the user pulls the moveable member 40 generally along the axis X away from the
hub 18 and slits the remaining portion of the tubular member 26 as it is pulled from
the body. It will be appreciated that the handle portion 48 creates a pulling force
on the tubular member 26, and the grip member 25 creates an opposing force to keep
the hub 18 generally stationary with respect to the body during this step. Thus, the
medical instrument 12 is less likely to move during slitting.
[0035] In some embodiments, the hub 18 further includes a guide loop 52 that at least partially
encompasses the elongate tubular member 26. In the embodiments illustrated, the guide
loop 52 is disposed adjacent the proximal end 20 of the hub 18, forward from first
coupling member 42. In some embodiments, the guide loop 52 is integrally attached
with the other portions of the hub 18 to be monolithic with the hub; however, the
guide loop 52 can be removably attached to the hub 18. It will be appreciated that
the guide loop 52 retains and guides the slit tubular member 26 generally along the
axis X as the moveable member 40 moves relative to the hub 18. Accordingly, the tubular
member 26 is less likely to twist along the axis X, and the medical instrument 12
is less likely to move during slitting.
[0036] Moreover, in some embodiments, the hub 18 further includes a guide fin 54 that extends
transversely away from the axis X adjacent the proximal end 20 of the hub 18, between
the guide loop 52 and the first coupling member 42. In some embodiments, the guide
fin 54 is integrally attached to remaining portions of the hub 18 so as to be monolithic
with the hub 18; however, the guide fin 54 can be removably coupled to the hub 18
as well. It will be appreciated that, as the tubular member 26 is pulled along the
hub 18, the guide fin 54 extends into the slit formed in the tubular member 26 and
generally inhibits rotation (i.e., twisting) of the tubular member 26 about the axis
X. Accordingly, the medical instrument 12 is less likely to be inadvertently moved
during slitting.
[0037] Also, in some embodiments, the hub 18 includes a recess 63 (FIG. 3) for coupling
the first coupling member 42 to the hub 18. In some embodiments, the recess 63 is
included proximally on the fin 54, and the first coupling member 42 is substantially
rounded so as to rotationally fit within the recess 63. Furthermore, in some embodiments,
the first coupling member 42 can include side members 62 (see FIGS. 1, 2, and 4).
In some embodiments, the side members 62 are thin flanges that extend over opposite
sides of the fin 54. The side members 62 generally retain the moveable member 40 for
pivoting about the axis R so as to retain the pivot axis R in a substantially perpendicular
position relative to the hub 18. Because of the mating of the recess 63 and the first
coupling member 42 and because of the side members 62, the tubular member 26 is more
likely to be pulled substantially straight along the axis X, and the instrument 12
is more likely to remain in position during slitting.
[0038] Referring back to the method of operating the catheter system 10, the user finishes
slitting and removing the tubular member 26 from the body. Subsequently, the valve
14 can be loosened, and the hub 18 can slide off from the medical instrument 12, leaving
the medical instrument 12 in the dcsircd position. In some embodiments, the hub 18
includes a longitudinal slot 56 (FIG. 3) adjacent the distal end 22 of the hub 18
on a side opposite to the grip member 25, and the slot 56 is in communication with
the lumen 24 to facilitate sliding removal of the hub 18 from over the medical instrument
12. Then, the medical instrument 12 is ready for further medical procedures, such
as attachment of a pacemaker.
[0039] Accordingly, the catheter system 10 allows for easy implantation (i.e., movement
and positioning) of the medical instrument 12. The slitting of the tubular member
26 can be performed more easily because the lever action of the moveable member 40.
Also, the system 10 can be performed by one person because of the various ergonomic
features described above. Moreover, the system 10 includes several features that inhibits
the tubular member 26 from twisting about its axis, thereby making it less likely
to inadvertently move the tubular member 26 during slitting. In addition, manufacture
of the catheter system 10 can be completed relatively quickly and less expensively
than systems of the prior art.
[0040] Moreover, in some embodiments, the system 10 can include a seal 60 for sealing the
tube coupling member 50 and/or the moveable member 40 to the hub 18. The seal 60 thereby
reduces contamination of the lumen 24 of the hub 18 and the lumen 28 of the tubular
member 26. In some embodiments, the seal 60 is a low strength adhesive, such as silicone;
however, it will be appreciated that the seal 60 could be made out of any suitable
material.
[0041] Specifically, in some embodiments, the seal 60 extends over the tube coupling member
50 and the outer surface 31 such that the slot 56 is substantially sealed. In other
embodiments, one seal 60 extends over one of the flanges 47 and the outer surface
31, and another seal 60 extends over another of the flanges 47. In still other embodiments,
the seal 60 is created by overmolding the tube coupling member 50 with the material
of the hub 18. For instance, in the embodiment of FIG. 9, the seal 360 is created
by overmolding the tube coupling member 50 with the material of the hub 18. It will
be appreciated that the seal 60, 360 is of a generally low strength and/or generally
does not adhere well to the hub 18 such that the seal 60, 360 breaks easily upon movement
of the moveable member 40, 340 relative to the hub 18, 318. Accordingly, the system
10, 310 is more likely to remain sanitary due to the seal 60, 360.
[0042] Referring now to FIGS. 6 and 7, the catheter system 110 is illustrated according
to various other embodiments of the present disclosure. It will be appreciated that
components similar to those of the embodiment of FIGS. 1-5 are identified by similar
reference numerals increased by 100.
[0043] In some embodiments, the catheter system 110 includes a moveable member 140 with
a handle member 148 that extends generally transverse to the axis X. In some embodiments,
the handle member 148 is substantially perpendicular to the axis X. The moveable member
140 is coupled to the hub 118 via a break-away tab 181 (FIG. 6). The break-away tab
181 can be formed to extend generally around the moveable member 140. The break-away
tab 181 can be formed using a relatively low strength adhesive that couples the moveable
member 140 and the hub 118. Also, the moveable member 140 and the hub 118 can be molded
together to be monolithic, and the break-away tab 181 can be a thin section of molded
material formed during this molding process.
[0044] The slitting procedure is somewhat similar to that discussed above. However, to begin
slitting, the break-away tab 181 is first broken. In some embodiments, the break-away
tab 181 is broken by pressing the moveable member 140 toward the axis X and toward
the hub 118. In some embodiments, the break-away tab 181 is further broken by pivoting
the moveable member 140 distally.
[0045] Once the break-away tab 181 has been broken, the moveable member 140 is pulled transversely
away from the axis X and away from the hub 118. Because of the tube coupling member
150, this movement advances and slits the tubular member 126 similar to the embodiments
of FIGS. 1-5. Next, the moveable member 140 is pulled generally along the axis X proximally
away from the hub 118 to complete slitting of the tubular member 126. Finally, the
hub 118 slides over the instrument 112 to complete the operation of the system 110.
[0046] In some embodiments, the distal end 122 of the hub 118 is removably coupled to other
portions of the hub 118. Thus, in the final step of removing the hub 118, the proximal
end 120 is removed from over the instrument 112, and then the distal end 122 is separately
removed from the instrument 112.
[0047] Referring now to FIG. 8, the catheter system 210 is illustrated according to various
other embodiments of the present disclosure. It will be appreciated that components
similar to those of the embodiment of FIGS. 1-5 are identified by similar reference
numerals increased by 200.
[0048] As shown, the catheter system 210 can include a guide loop 252 that is removably
attached to the hub 218. The guide loop 252 can be coupled via a snap fit. Accordingly,
in some embodiments, by including a guide loop 252 that is removably attached, the
manufacturability of the system 210 can be increased. Also, the distal end 222 of
the hub 218 and the distal end 280 of the moveable member 240 cooperate to define
a rounded opening 282. The rounded opening 282 encompasses the tubular member 226
and can further seal the system 210 from contaminants.
[0049] Furthermore, the system 210 can include a trigger member 272 adjacent the distal
end 222 of the hub 218 on a side opposite to the moveable member 240. The trigger
member 272 extends generally transverse to the axis X. The trigger member 272 is resiliently
flexible. Also, the second coupling member 244 removably couples to the trigger member
272. More specifically, when the user holds the grip member 225, the user can also
resiliently squeeze the trigger member 272 toward the grip member 225 with the same
hand. This movement causes the protrusions 270 to move out of the corresponding grooves
268 to detach the second coupling member 244 from the hub 218. Accordingly, the trigger
member 272 provides a greater amount of control during slitting.
[0050] Referring now to FIG. 9, the catheter system 310 is illustrated according to various
other embodiments of the present disclosure. It will be appreciated that like components
similar to those of the embodiment of FIGS. 1-5 are identified by similar reference
numerals increased by 300.
[0051] As shown, the rounded back surface 364 includes a camming feature 366 (FIG. 9). It
will be appreciated that, as the moveable member 340 begins rotating on the back surface
364, the camming feature 366 cams the moveable member 340 up and away from the hub
18. Accordingly, the camming feature 366 ergonomically aids the user in pulling the
moveable member 340 from the hub 318 for slitting purposes.
[0052] Furthermore, the system 310 includes reliefs 384 in the distal end 322 of the hub
318 and the distal end 380 of the moveable member 340. The reliefs 384 can increase
the manufacturability of the system 310 and can increase the flexibility of the system
310 for greater control during slitting of the tubular member 326.
[0053] Certain terminology is used herein for purposes of reference only, and thus is not
intended to be limiting. For example, terms such as "upper," "lower," "above," "below,"
"top," "upward," and "downward" refer to directions in the drawings to which reference
is made. Terms such as "front," "back," "rear," and "side," describe the orientation
of portions of the component within a consistent but arbitrary frame of reference
which is made clear by reference to the text and the associated drawings describing
the component under discussion. Such terminology may include the words specifically
mentioned above, derivatives thereof, and words of similar import. Similarly, the
terms "first," "second," and other such numerical terms referring to structures do
not imply a sequence or order unless clearly indicated by the context.
[0054] When introducing elements or features and the exemplary embodiments, the articles
"a," "an," "the" and "said" are intended to mean that there are one or more of such
elements or features. The terms "comprising," "including," and "having" are intended
to be inclusive and mean that there may be additional elements or features other than
those specifically noted. It is further to be understood that the method steps, processes,
and operations described herein are not to be construed as necessarily requiring their
performance in the particular order discussed or illustrated, unless specifically
identified as an order of performance. It is also to be understood that additional
or alternative steps may be employed.
[0055] The description of the disclosure is merely exemplary in nature and, thus, variations
that do not depart from the gist of the disclosure are intended to be within the scope
of the disclosure. Such variations are not to be regarded as a departure from the
scope of the invention as defined by the claims.
1. A catheter system for positioning of an instrument within a body, the catheter system
comprising:
a hub (18) defining a lumen (23) therethrough for passage of the instrument toward
the body;
an elongate tubular member (26) defining a lumen (28) therethrough, the lumen of the
elongate tubular member being in communication with the lumen of the hub for further
passage of the instrument toward the body;
a slitter member (29) that is coupled to the hub, the slitter member disposed to slit
the elongate tubular member;
characterised in that
a moveable member (40) that is moveably coupled to the hub and that is coupled to
the elongate tubular member, the moveable member operable to advance the elongate
tubular member toward the slitter member as the moveable member is moved relative
to the hub, thereby slitting the elongate tubular member.
2. The catheter system of Claim 1 , wherein the moveable member is rotationally coupled
to the hub, and preferably wherein the moveable member is rotationally coupled to
the hub generally about a pivot axis that is substantially transverse to a longitudinal
axis of the lumen of the hub, and further preferably wherein the moveable member includes
a handle portion (48) and a lever portion (49) that spaces the handle portion from
the pivot axis to provide a mechanical advantage while advancing the elongate tubular
member toward the slitter member.
3. The catheter system of Claim 2, further comprising a tube coupling member (50) that
couples the moveable member and the elongate tubular member, and preferably wherein
the tube coupling member and the elongate tubular member are monolithic.
4. The catheter system of Claim 2, wherein the moveable member is configured to pull
the elongate tubular member toward the slitter member as the moveable member rotates
about the pivot axis.
5. The catheter system of Claim 2, wherein the moveable member includes a rounded back
surface (66) upon which the moveable member is rotatably supported on the hub, and
preferably wherein the rounded back surface includes a camming feature that cams the
moveable member away from the hub as the moveable member rotates.
6. The catheter system of Claim 2, further comprising side members (62) that generally
retain the pivot axis in position relative to the hub.
7. The catheter system of Claim 1 , wherein the moveable member is removably coupled
to the hub, and preferably wherein the moveable member is rotationally coupled to
the hub at a rotational coupling, wherein the rotational coupling removably couples
the moveable member to the hub, and further preferably wherein the moveable member
is configured to pull the elongate tubular member toward the slitter member as the
moveable member rotates about the rotational coupling, and wherein the moveable member
is further configured to pull the elongate tubular member toward the slitter member
after the moveable member is detached from the hub.
8. The catheter system of Claim 1, wherein the hub defines a proximal end and a distal
end, and wherein the moveable member is removably coupled to the hub generally at
a first coupling member (42) and a second coupling member (44), the first coupling
member disposed generally adjacent the proximal end of the hub and the second coupling
member disposed generally adjacent the distal end of the hub.
9. The catheter system of Claim 1, further comprising a coupling fork (43) that removably
couples the moveable member to the hub, the coupling fork including a first arm (45)
and a second arm (47) that removably couple to opposing sides of at least one of the
hub and the moveable member, and preferably wherein the coupling fork includes at
least one of a grooved portion (68) and a protrusion (70), and the hub includes the
other of the grooved portion and the protrusion, and wherein the grooved portion receives
the protrusion to removably couple the coupling fork and the hub, and further preferably
wherein the hub further includes a trigger member that is resiliently flexible to
resiliently move the other of the grooved portion and the protrusion to thereby detach
the grooved portion and the protrusion.
10. The catheter system of Claim 1, further comprising a guide loop (52) that encompasses
the elongate tubular member to guide the elongate tubular member as the moveable member
is moved relative to the hub.
11. The catheter system of Claim 1 , wherein the slitter member forms a slit longitudinally
in the elongate tubular member, and further comprising a guide fin that extends into
the slit to guide the elongate tubular member as the moveable member is moved relative
to the hub.
12. The catheter system of Claim 1 , wherein the hub includes a longitudinal slot (56)
that is in communication with the lumen of the hub.
13. The catheter system of Claim 1 , wherein the moveable member is configured to create
a pulling force on elongate tubular member to advance the elongate tubular member
toward the slitter member, the hub further including a grip member configured to be
gripped to create an opposing force that generally opposes the pulling force.
14. The catheter system of Claim 1 , wherein the moveable member is rotatably coupled
to the hub via a first coupling member, and wherein the hub includes a recess that
receives the first coupling member for rotation therein.
15. The catheter system of Claim 1, wherein an outer surface of the hub is tapered, and
wherein the tubular member advances over the outer surface as the moveable member
moves relative to the hub.
1. Kathetersystem zum Positionieren eines Instruments in einem Körper, wobei das Kathetersystem
enthält:
eine Buchse (18), die einen durch sie verlaufenden Hohlraum (23) für den Durchgang
des Instruments zu dem Körper definiert;
ein lang gestrecktes rohrförmiges Element (26), das einen durch es verlaufenden Hohlraum
(28) definiert, wobei der Hohlraum des lang gestreckten rohrförmigen Elements mit
dem Hohlraum der Buchse für einen weiteren Durchgang des Instruments zu dem Körper
in Kommunikation ist;
ein Schneidelement (29), das mit der Buchse gekoppelt ist, wobei das Schneidelement
so angeordnet ist, dass es das lang gestreckte rohrförmige Element schneidet;
dadurch gekennzeichnet, dass
ein bewegliches Element (40), das mit der Buchse beweglich gekoppelt ist und das mit
dem lang gestreckten rohrförmigen Element gekoppelt ist, betreibbar ist, um das lang
gestreckte rohrförmige Element zu dem Schneid-element vorwärts zu bewegen, wenn das
bewegliche Element relativ zu der Buchse bewegt wird, wodurch das lang gestreckte
rohrförmige Element geschnitten wird.
2. Kathetersystem nach Anspruch 1, wobei das bewegliche Element mit der Buchse drehbar
gekoppelt ist und wobei vorzugsweise das bewegliche Element mit der Buchse im Allgemeinen
um eine Schwenkachse, die im Wesentlichen quer zu der Längsachse des Hohlraums der
Buchse verläuft, drehbar gekoppelt ist und wobei ferner vorzugsweise das bewegliche
Element einen Griffabschnitt (48) und einen Hebelabschnitt (49), der den Griffabschnitt
von der Schwenkachse beabstandet, um einen mechanischen Nutzen zu schaffen, während
das lang gestreckte rohrförmige Element zu dem Schneidelement vorwärts bewegt wird,
enthält.
3. Kathetersystem nach Anspruch 2, das ferner ein Rohrkopplungselement (50) enthält,
das das bewegliche Element und das lang gestreckte rohrförmige Element koppelt, wobei
vorzugsweise das Rohrkopplungselement und das lang gestreckte rohrförmige Element
monolithisch sind.
4. Kathetersystem nach Anspruch 2, wobei das bewegliche Element konfiguriert ist, um
das lang gestreckte rohrförmige Element zu dem Schneidelement zu ziehen, wenn sich
das bewegliche Element um die Schwenkachse dreht.
5. Kathetersystem nach Anspruch 2, wobei das bewegliche Element eine abgerundete hintere
Oberfläche (66) aufweist, auf der das bewegliche Element auf der Buchse drehbar unterstützt
ist, und wobei vorzugsweise die abgerundete hintere Oberfläche ein Kämm-Merkmal aufweist,
das das bewegliche Element von der Buchse wegkämmt, wenn sich das bewegliche Element
dreht.
6. Kathetersystem nach Anspruch 2, das ferner Seitenelemente (62) enthält, die die Schwenkachse
im Allgemeinen an ihrer Position relativ zu der Buchse halten.
7. Kathetersystem nach Anspruch 1, wobei das bewegliche Element mit der Buchse lösbar
gekoppelt ist und wobei vorzugsweise das bewegliche Element mit der Buchse an einer
Drehkopplung drehbar gekoppelt ist, wobei die Drehkopplung das bewegliche Element
mit der Buchse lösbar koppelt, und wobei ferner vorzugsweise das bewegliche Element
konfiguriert ist, um das lang gestreckte rohrförmige Element zu dem Schneidelement
zu ziehen, wenn sich das bewegliche Element um die Drehkopplung dreht, und wobei das
bewegliche Element ferner konfiguriert ist, das lang gestreckte rohrförmige Element
zu dem Schneidelement zu ziehen, nachdem das bewegliche Element von der Buchse gelöst
worden ist.
8. Kathetersystem nach Anspruch 1, wobei die Buchse ein proximales Ende und ein distales
Ende definiert und wobei das bewegliche Element mit der Buchse im Allgemeinen an einem
ersten Kopplungselement (42) und an einem zweiten Kopplungselement (44) gekoppelt
ist, wobei das erste Kopplungselement im Allgemeinen in der Nähe des proximalen Endes
der Buchse angeordnet ist und das zweite Kopplungselement im Allgemeinen in der Nähe
des distalen Endes der Buchse angeordnet ist.
9. Kathetersystem nach Anspruch 1, das ferner eine Kopplungsgabel (43) aufweist, die
das bewegliche Element mit der Buchse lösbar koppelt, wobei die Kopplungsgabel einen
ersten Arm (45) und einen zweiten Arm (47) enthält, die mit gegenüberliegenden Seiten
der Buchse und/oder des beweglichen Elements lösbar gekoppelt sind, und wobei vorzugsweise
die Kopplungsgabel einen Nutabschnitt (68) und/oder einen Vorsprung (70) enthält und
wobei die Buchse den jeweils Anderen des Nutabschnitts bzw. des Vorsprungs enthält
und wobei der Nutabschnitt den Vorsprung aufnimmt, um die Kopplungsgabel mit der Buchse
lösbar zu koppeln und wobei ferner vorzugsweise die Buchse ein Auslöseelement enthält,
das elastisch biegsam ist, um den Anderen des Nutabschnitts bzw. des Vorsprungs elastisch
zu bewegen, um dadurch den Nutabschnitt und den Vorsprung zu lösen.
10. Kathetersystem nach Anspruch 1, das ferner eine Führungsschleife (52) enthält, die
das lang gestreckte rohrförmige Element umgibt, um das lang gestreckte rohrförmige
Element zu führen, wenn das bewegliche Element relativ zu der Buchse bewegt wird.
11. Kathetersystem nach Anspruch 1, wobei das Schneidelement einen Schlitz in Längsrichtung
des lang gestreckten rohrförmigen Elements bildet, das ferner einen Führungssteg aufweist,
der sich in den Schlitz erstreckt, um das lang gestreckte rohrförmige Element zu führen,
wenn das bewegliche Element relativ zu der Buchse bewegt wird.
12. Kathetersystem nach Anspruch 1, wobei die Buchse einen longitudinalen Schlitz (56)
aufweist, der mit dem Hohlraum der Buchse in Kommunikation steht.
13. Kathetersystem nach Anspruch 1, wobei das bewegliche Element konfiguriert ist, um
eine Zugkraft auf das lang gestreckte rohrförmige Element zu erzeugen, um das lang
gestreckte rohrförmige Element zu dem Schneidelement vorwärts zu bewegen, wobei die
Buchse ferner ein Griffelement enthält, das konfiguriert ist, ergriffen zu werden,
um eine Gegenkraft zu erzeugen, die der Zugkraft im Allgemeinen entgegen wirkt.
14. Kathetersystem nach Anspruch 1, wobei das bewegliche Element mit der Buchse über ein
erstes Kopplungselement drehbar gekoppelt ist und wobei die Buchse eine Aussparung
aufweist, die das erste Kopplungselement für eine Drehung darin aufnimmt.
15. Kathetersystem nach Anspruch 1, wobei eine äußere Oberfläche der Nabe konisch verjüngt
ist und wobei sich das rohrförmige Element über die äußere Oberfläche vorwärts bewegt,
wenn sich das bewegliche Element relativ zu der Buchse bewegt.
1. Système de cathéter pour positionner un instrument à l'intérieur d'un corps, le système
de cathéter comportant :
un moyeu (18) définissant une lumière (23) à travers celui-ci pour le passage de l'instrument
vers le corps ;
un élément tubulaire allongé (26) définissant une lumière (28) à travers celui-ci,
la lumière de l'élément tubulaire allongé étant en communication avec la lumière du
moyeu pour un passage supplémentaire de l'instrument vers le corps ;
un élément de dispositif de coupe (29) qui est couplé au moyeu, l'élément de dispositif
de coupe étant disposé pour découper l'élément tubulaire allongé ; caractérisé en ce que
un élément mobile (40) qui est couplé de manière mobile au moyeu et qui est couplé
à l'élément tubulaire allongé, l'élément mobile étant opérationnel pour faire avancer
l'élément tubulaire allongé vers l'élément de coupe lorsque l'élément mobile est déplacé
par rapport au moyeu, de manière à découper l'élément tubulaire allongé.
2. Système de cathéter selon la revendication 1, dans lequel l'élément mobile est couplé
en rotation au moyeu et, de manière préférée, dans lequel l'élément mobile est couplé
en rotation au moyeu généralement autour d'un axe de pivotement qui est sensiblement
transversal à un axe longitudinal de la lumière du moyeu et, en outre, de manière
préférée, dans lequel l'élément mobile comprend une partie de poignée (48) et une
partie de levier (49) qui espace la partie de poignée de l'axe de pivotement pour
fournir un avantage mécanique tout en faisant avancer l'élément tubulaire allongé
vers l'élément de dispositif de coupe.
3. Système de cathéter selon la revendication 2, comportant en outre un élément de couplage
de tube (50) qui couple l'élément mobile et l'élément tubulaire allongé et, de manière
préférée, dans lequel l'élément de couplage de tube et l'élément tubulaire allongé
sont monolithiques.
4. Système de cathéter selon la revendication 2, dans lequel l'élément mobile est configuré
pour tirer l'élément tubulaire allongé vers l'élément de dispositif de coupe lorsque
l'élément mobile tourne autour de l'axe de pivotement.
5. Système de cathéter selon la revendication 2, dans lequel l'élément mobile inclut
une surface arrondie (66) sur laquelle l'élément mobile est supporté en rotation sur
le moyeu et, de manière préférée, dans lequel la surface arrondie comprend une fonction
de retour à effet de came qui éloigne l'élément mobile du moyeu lorsque l'élément
mobile tourne.
6. Système de cathéter selon la revendication 2, comportant en outre des éléments latéraux
(62) qui conservent généralement l'axe de pivotement en position par rapport au moyeu.
7. Système de cathéter selon la revendication 1, dans lequel l'élément mobile est couplé
de manière amovible au moyeu et, de manière préférée, dans lequel l'élément mobile
est couplé en rotation au moyeu au niveau d'un couplage de rotation, dans lequel le
couplage de rotation couple de manière amovible l'élément mobile au moyeu, et en outre
de préférence dans lequel l'élément mobile est configuré pour tirer l'élément tubulaire
allongé vers l'élément de dispositif de coupe lorsque l'élément mobile tourne autour
du couplage de rotation, et dans lequel l'élément mobile est en outre configuré pour
tirer l'élément tubulaire allongé vers l'élément de dispositif de coupe une fois que
l'élément mobile est détaché du moyeu.
8. Système de cathéter selon la revendication 1, dans lequel le moyeu définit une extrémité
proximale et une extrémité distale, et dans lequel l'élément mobile est couplé de
manière amovible au moyeu généralement au niveau d'un premier élément de couplage
(42) et d'un second élément de couplage (44), le premier élément de couplage étant
disposé généralement à proximité adjacente de l'extrémité proximale du moyeu et le
second élément de couplage étant disposé généralement à proximité adjacente de l'extrémité
distale du moyeu.
9. Système de cathéter selon la revendication 1, comportant en outre une fourchette d'accouplement
(43) qui couple de manière amovible l'élément mobile au moyeu, la fourchette d'accouplement
comprenant un premier bras (45) et un second bras (47) qui sont couplés de manière
amovible à des côtés opposés d'au moins l'un du moyeu et de l'élément mobile et, de
manière préférée, dans lequel la fourchette de couplage comprend au moins l'une d'une
partie rainurée (68) et d'une saillie (70), et le moyeu inclut l'autre de la partie
rainurée et de la saillie, et dans lequel la partie rainurée reçoit la saillie pour
coupler de manière amovible la fourchette d'accouplement et le moyeu et, en outre,
de manière préférée, dans lequel le moyeu comprend de plus un élément de déclenchement
qui est flexible de manière élastique pour déplacer de manière élastique l'autre de
la partie rainurée et de la saillie de manière à détacher la partie rainurée et la
saillie.
10. Système de cathéter selon la revendication 1, comportant en outre une boucle de guidage
(52) qui englobe l'élément tubulaire allongé pour guider l'élément tubulaire allongé
lorsque l'élément tubulaire est déplacé par rapport au moyeu.
11. Système de cathéter selon la revendication 1, dans lequel l'élément de dispositif
de coupe forme une fente longitudinalement dans l'élément tubulaire allongé, et comportant
en outre une ailette de guidage qui s'étend dans la fente pour guider l'élément tubulaire
allongé lorsque l'élément mobile est déplacé par rapport au moyeu.
12. Système de cathéter selon la revendication 1, dans lequel le moyeu comprend une fente
longitudinale (56) qui est en communication avec la lumière du moyeu.
13. Système de cathéter selon la revendication 1, dans lequel l'élément mobile est configuré
pour créer une force de traction sur l'élément tubulaire allongé afin de faire avancer
l'élément tubulaire allongé vers l'élément de dispositif de coupe, le moyeu comprenant
en outre un élément de préhension configuré pour être saisi afin de créer une force
opposée qui s'oppose généralement à la force de traction.
14. Système de cathéter selon la revendication 1, dans lequel l'élément mobile est couplé
en rotation au moyeu par l'intermédiaire d'un premier élément de couplage, et dans
lequel le moyeu comprend un évidement qui reçoit le premier élément de couplage pour
une rotation dans celui-ci.
15. Système de cathéter selon la revendication 1, dans lequel une surface extérieure du
moyeu est conique, et dans lequel l'élément tubulaire avance sur la surface extérieure
lorsque l'élément mobile se déplace par rapport au moyeu.